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Value-Based Care Transformation Services

Our unique value-based care transformation services facilitate collaboration between payers and providers to improve patient care outcomes and to leverage analytics and care coordination to support success in value-based care.

 

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TransitionTo Value-Based Care

  • Collaborate effectively with healthcare stakeholders. Our services help payers and providers work together to support high quality, efficient care.

  • Empower primary care providers to own their patients’ treatment plans. All shared savings program participants are independent primary care providers who are best positioned to improve care quality and efficiency.

  • Leverage care coordination to support patients. Our experienced team of nurses and social workers actively engage patients to help them reach the goals set between patients and their providers.
  • Earn shared savings and improve care. Providers can generate shared savings without contributing any upfront financial costs or committing to any shared risks.

  • Access actionable patient data using our analytics tools and capabilities. Our dedicated and experienced analytics team works with claims-based data to support practice transformation, strategy development, and patient care improvements.

  • Identify patients who need higher quality, lower-cost care. Data and analytics services help identify patients to receive focused, active support from care coordination resources.

Improve Patient Care While Lowering Costs

  • Enhance care efficiency and reduce costs

    • Earn shared savings for both payers and primary care providers by meeting selected efficiency and cost measures. This aligns incentives and empowers physicians to provide effective and efficient care to patients.
    • Increase program participation within a state’s provider community by offering our effective suite of services to independent primary care providers without any upfront costs or shared risk contracts.
    • Improve Medical Loss Ratios for participating payers to support their transition from fee-for-service to value-based care.

  • Improve patient health

    • Access and analyze claims-based data from payers on tailored medical, pharmaceutical, and efficiency metrics to gain visibility into cost drivers and quality risks within a participating patient population.
    • Get detailed insights at the individual patient level from claims-based data. This allows you to give providers information about opportunities to adjust patient care plans to meet cost and quality benchmark goals.
    • Improve the overall health of the participating population by developing effective local networks of primary care and specialty providers to care for the patients who account for the highest costs and represent the most significant risk.

  • Improve the patient care experience

    • Offer independent primary care providers a broad range of data and care coordination services to help them provide the most effective care to patients.
    • Focus care coordination resources on patients who have the most opportunity for cost and quality improvements and provide personalized care to patients.
    • Create more satisfied patients who are motivated to work with their providers to improve their own health. This can lead to long-term cost savings and a more efficient use of healthcare services.

Our outcomes

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White Paper

Risk Adjustment Methodology of Prometheus Analytics

White Paper

Risk Adjustment Methodology of Prometheus Analytics

Explore how providing different risk adjustment models for each episode of care captures the episode-specific contribution of risk factors to resource use.

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Case Study

Insights, Metrics, and Clinical Support Help Primary Care Providers Achieve VBC Success

Case Study

Insights, Metrics, and Clinical Support Help Primary Care Providers Achieve VBC Success

Learn how a health plan improved the overall quality of care while helping independent PCPs and practices meet requirements of an alternative payment program.

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Article

The Interoperability Imperative

Article

The Interoperability Imperative

Learn more about how interoperability unlocks silos in enterprise applications and connects the business logic needed to support value-based reimbursement.

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